Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
|
Total |
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Calendar year (or fiscal year beginning in) ![]() |
(a) 2016 | (b) 2017 | (c) 2018 | (d) 2019 | (e) 2020 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | 79,200 | 87,100 | 789,679 | 6,996,280 | 175,702 | 8,127,961 |
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3 | 79,200 | 87,100 | 789,679 | 6,996,280 | 175,702 | 8,127,961 |
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f).. | ||||||
| 6 | Public support. Subtract line 5 from line 4. | 8,127,961 | |||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2016 | (b) 2017 | (c) 2018 | (d) 2019 | (e) 2020 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 79,200 | 87,100 | 789,679 | 6,996,280 | 175,702 | 8,127,961 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 1,081 | 1,081 | ||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10 | 8,129,042 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2016 | (b) 2017 | (c) 2018 | (d) 2019 | (e) 2020 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | ||||||
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose | ||||||
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513 ..... | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge | ||||||
| 6 | Total. Add lines 1 through 5 | ||||||
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | ||||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | ||||||
| c | Add lines 7a and 7b.. | ||||||
| 8 | Public support. (Subtract line 7c from line 6.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2016 | (b) 2017 | (c) 2018 | (d) 2019 | (e) 2020 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | ||||||
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | ||||||
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
|||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by 0.035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2020 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2020 |
(iii) Distributable Amount for 2020 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2020 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions. |
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| 3 Excess distributions carryover, if any, to 2020: | ||||
| a From 2015....... | ||||
| b From 2016....... | ||||
| c From 2017....... | ||||
| d From 2018....... | ||||
| e From 2019....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2020 distributable amount | ||||
|
i
Carryover from 2015 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2020 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2020 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2020, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2020. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
7 Excess distributions carryover to 2021. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2016..... | ||||
| b Excess from 2017..... | ||||
| c Excess from 2018..... | ||||
| d Excess from 2019..... | ||||
| e Excess from 2020..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990 - ORGANIZATION'S MISSION | THE ORGANIZATION'S MISSION IS TO FULFILL THE UNMET NEEDS OF INDIVIDUALS AND FAMILIES TO BUILD A HEALTHIER COMMUNITY. WE AMELIORATE BARRIERS TO PRIMARY CARE BY EXPANDING MEDICAL CARE SERVICES TO REACH LOW-INCOME INDIVIDUALS REGARDLESS OF THEIR ABILITY TO PAY. WE PROVIDE PRIMARY MEDICAL CARE, WELL CHILD VISITS INCLUDING IMMUNIZATIONS, STD/HIV SCREENING AND TREATMENT, AND HIV PREVENTION SERVICES TO LOW-INCOME INDIVIDUALS WITH A SERVICE DELIVERY MODEL THAT ASSURES THE INTEGRATION OF ENABLING SERVICES INCLUDING CASE MANAGEMENT, OUTREACH, TRANSPORTATION, ON-SITE PHARMACY, AND ACCESS TO A CONTINUUM OF CARE AND SPECIAL CARE SERVICES. SECTION 340B IS A US FEDERAL GOVERNMENT PROGRAM CREATED IN 1992 THAT REQUIRES DRUG MANUFACTURERS TO PROVIDE OUTPATIENT DRUGS TO ELIGIBLE HEALTH CARE ORGANIZATIONS AND COVERED ENTITIES AT SIGNIFICANTLY REDUCED PRICES. THE INTENT OF THE PROGRAM IS TO ALLOW COVERED ENTITIES TO STRETCH SCARCE FEDERAL RESOURCES AS FAR AS POSSIBLE, REACHING MORE ELIGIBLE PATIENTS AND PROVIDING MORE COMPREHENSIVE SERVICES. MAINTAINING SERVICES AND LOWERING MEDICATION COSTS FOR PATIENTS IS CONSISTENT WITH THE PURPOSE OF THE PROGRAM, WHICH IS NAMED FOR THE SECTION AUTHORIZING IT IN THE PUBLIC HEALTH SERVICE ACT IN CASES WHERE THE COVERED ENTITY TREATS AN INSURED PATIENT WITH DISCOUNTED MEDICATION, THE FEDERAL GOVERNMENT OR THE PATIENT'S PRIVATE INSURANCE ROUTINELY REIMBURSES THE ENTITY FOR THE FULL PRICE OF THE MEDICATION, AND THE ENTITY IS ABLE TO RETAIN THE DIFFERENCE BETWEEN THE REDUCED PRICE IT PAYS FOR THE DRUG AND THE FULL AMOUNT FOR WHICH IT IS REIMBURSED. |
| FORM 990, PAGE 2, PART III, LINE 4A | THE ORGANIZATION'S MISSION IS TO FULFILL THE UNMET NEEDS OF INDIVIDUALS AND FAMILIES TO BUILD A HEALTHIER COMMUNITY. WE AMELIORATE BARRIERS TO PRIMARY CARE BY EXPANDING MEDICAL CARE SERVICES TO REACH LOW-INCOME INDIVIDUALS REGARDLESS OF THEIR ABILITY TO PAY. WE PROVIDE PRIMARY MEDICAL CARE, WELL CHILD VISITS INCLUDING IMMUNIZATIONS, STD/HIV SCREENING AND TREATMENT, AND HIV PREVENTION SERVICES TO LOW-INCOME INDIVIDUALS WITH A SERVICE DELIVERY MODEL THAT ASSURES THE INTEGRATION OF ENABLING SERVICES INCLUDING CASE MANAGEMENT, OUTREACH, TRANSPORTATION, ON-SITE PHARMACY, AND ACCESS TO A CONTINUUM OF CARE AND SPECIAL CARE SERVICES, INCLUDING COVID-19 TESTING AND VACCINES. SECTION 340B IS A US FEDERAL GOVERNMENT PROGRAM CREATED IN 1992 THAT REQUIRES DRUG MANUFACTURERS TO PROVIDE OUTPATIENT DRUGS TO ELIGIBLE HEALTH CARE ORGANIZATIONS AND COVERED ENTITIES AT SIGNIFICANTLY REDUCED PRICES. THE INTENT OF THE PROGRAM IS TO ALLOW COVERED ENTITIES TO STRETCH SCARCE FEDERAL RESOURCES AS FAR AS POSSIBLE, REACHING MORE ELIGIBLE PATIENTS AND PROVIDING MORE COMPREHENSIVE SERVICES. MAINTAINING SERVICES AND LOWERING MEDICATION COSTS FOR PATIENTS IS CONSISTENT WITH THE PURPOSE OF THE PROGRAM, WHICH IS NAMED FOR THE SECTION AUTHORIZING IT IN THE PUBLIC HEALTH SERVICE ACT IN CASES WHERE THE COVERED ENTITY TREATS AN INSURED PATIENT WITH DISCOUNTED MEDICATION, THE FEDERAL GOVERNMENT OR THE PATIENT'S PRIVATE INSURANCE ROUTINELY REIMBURSES THE ENTITY FOR THE FULL PRICE OF THE MEDICATION, AND THE ENTITY IS ABLE TO RETAIN THE DIFFERENCE BETWEEN THE REDUCED PRICE IT PAYS FOR THE DRUG AND THE FULL AMOUNT FOR WHICH IT IS REIMBURSED. IN 2020, CARE 4 U PROVIDED HEALTH CARE SERVICES TO OVER 2,500 MEN, WOMEN AND CHILDREN -- THE MAJORITY OF WHICH WERE UNINSURED. THROUGH OUR HIV/STD PROGRAM, WE DIAGNOSED AND/OR TREATED OVER 500 PEOPLE FOR STDS, INCLUDING OVER 100 PEOPLE LIVING WITH HIV. IN ADDITION, MORE THAN 600 PEOPLE AT HIGH-RISK FOR HIV INFECTION WERE PRESCRIBED PREP TO REDUCE THEIR RISK OF CONTRACTING THE DISEASE. WE ALSO PROVIDED OVER 5,000 COVID-19 SCREENINGS. |
| FORM 990, PAGE 6, PART VI, LINE 11B | THE ORGANIZATION'S BOARD OF DIRECTORS MEET AND REVIEW THE FORM 990 ALONG WITH A DRAFT OF THE AUDITED FINANCIAL STATEMENTS BEFORE THE 990 WAS FILED WITH THE INTERNAL REVENUE SERVICE. |
| FORM 990, PAGE 6, PART VI, LINE 12C | ANYONE SUBJECT TO THE CONFLICT OF INTEREST POLICY SHALL REPORT THE POSSIBLE EXISTENCE OF A CONFLICT OF INTEREST TO THE ORGANIZATION'S PRESIDENT. IN THE EVENT THAT THE PERSON IN QUESTION IS THE PRESIDENT, SAID REPORT SHALL BE MADE TO THE NEXT PREDECESSOR OF THE ORGANIZATION. A FULL DISCLOSURE OF ALL FACTS PERTAINING TO ANY TRANSACTION THAT IS SUBJECT TO ANY DOUBT CONCERNING THE POSSIBLE EXISTENCE OF A CONFLICT OF INTEREST SHALL BE MADE TO THE PRESIDENT BEFORE CONSUMMATING THE TRANSACTION. A BOARD MEMBER MAY NOT BECOME INVOLVED IN A TRANSACTION WITH THE ORGANIZATION IF THERE EXISTS OR APPEARS T EXIST A CONFLICT OF INTEREST, EXCEPT WITH THE CONSENT OF THE PRESIDENT AFTER FULL DISCLOSURE. INDIVIDUALS WHO KNOWINGLY VIOLATE AND/OR REFUSE TO ABIDE BY THIS POLICY MAY BE SUBJECT TO TERMINATION OF THEIR RELATIONSHIP WITH THE ORGANIZATION. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE ORGANIZATION'S BOARD REVIEWS AND SETS COMPENSATION. COMPENSATION IS DETERMINED BASED ON PERFORMANCE, QUALIFICATION AND ECONOMIC FACTORS. THE BOARD WILL REVIEW THE COMPENSATION SCALE AT THE END OF THE ANNUAL EMPLOYMENT CONTRACTS BASED ON SIMILAR POSITIONS IN THE IMMEDIATE GEOGRAPHIC ARE AS WELL AS THOSE THROUGHOUT THE REGION. |
| FORM 990, PAGE 6, PART VI, LINE 15B | THE ORGANIZATION'S BOARD PERIODICALLY REVIEWS AND SETS COMPENSATION. COMPENSATION WAS DETERMINED BASED ON PERFORMANCE, QUALIFICATION AND ECONOMIC FACTORS. THE BOARD WILL REVIEW THE COMPENSATION SCALE AT THE END OF THE ANNUAL EMPLOYMENT CONTRACTS BASED ON SIMILAR POSITIONS IN THE IMMEDIATE GEOGRAPHIC ARE AS WELL AS THOSE THROUGHOUT THE REGION. |
| FORM 990, PAGE 6, PART VI, LINE 19 | NO DOCUMENTS AVAILABLE TO THE PUBLIC |
| Software ID: | |
| Software Version: |